A 2-year-old boy is brought to the emergency department because of fever and poor feeding for 2 days. He became very fussy the previous evening and cried for most of the night. Examination shows a stiff neck. The pupils are equal and reactive to light. Neck flexion results in flexion of the knee and hip. Muscle strength is decreased in the right upper extremity. Laboratory results are as follows: While being evaluated, the patient develops apnea and asystole. Despite aggressive resuscitation efforts, the patient dies. Autopsy would most likely reveal which of the following?

Question

A 2-year-old boy is brought to the emergency department because of fever and poor feeding for 2 days. He became very fussy the previous evening and cried for most of the night. Examination shows a stiff neck. The pupils are equal and reactive to light. Neck flexion results in flexion of the knee and hip. Muscle strength is decreased in the right upper extremity. Laboratory results are as follows:  While being evaluated, the patient develops apnea and asystole.  Despite aggressive resuscitation efforts, the patient dies.  Autopsy would most likely reveal which of the following?

Quizplus · Accepted Answer

Eductional Objective: Meningococcal meningitis is a rapidly progressive infection that can spread systemically (ie, meningococcemia) and lead to septic shock, multiorgan failure, and disseminated intravascular coagulation.  Meningococcemia is also associated with bilateral hemorrhagic infarction of the adrenal glands, which can result in acute adrenal insufficiency (Waterhouse-Friderichsen syndrome) with worsening shock and rapid clinical deterioration.

A 2-Year-Old Boy Is Brought to the Emergency Department Because